Letter to the Editor: Non-selective bilateral internal iliac artery embolization is a safe and effective way in hemorrhage control for hemodynamically unstable pelvic fractures

Abstract

A recently published article by Lai et al. in BMC Musculoskeletal Disorders trying to show that patients with pelvic fractures undergoing non-selective internal iliac artery embolization may lead to a higher rate of surgical site infection. The authors also noted that only a small percentage of patients with contrast extravasation detected by emergency contrast-enhanced CT were subsequently confirmed by angiography, thus, considered that the value of enhanced CT in predicting arterial injury was limited. The authors also believe that embolization of the main stem may cause incomplete hemostasis due to the abundant collateral circulations in the pelvic cavity. Although the author’s findings are mentioned in other studies, the article’s data and pictures only partially supported its inferences, and the conclusions cannot be drawn directly. In this Correspondence, we tried to reinterpret the additional findings in the article from our perspective. Through this discussion, we hope that more colleagues can re-understand the safety and effectiveness of non-selective internal iliac artery embolization in treating hemodynamically unstable pelvic fractures during the early resuscitation stage.

The diameter of the gelatin sponge affects the outcome of pelvic internal iliac artery embolization

“…We highly agree with the authors' choice of trunk embolization when performing internal iliac artery embolization, a method perceived to have high effectiveness and avoid a series of complications resulting from selective embolization 3 . It was found that internal iliac artery trunk embolization can achieve adequate hemostasis of pelvic fractures without causing ischemia of the organs.…”